Benign prostatic hyperplasia (BPH) is one of the most common diseases of the genitourinary system. The prevalence of BPH increases in men with advancing age. While transurethral resection of the prostate gland entails complications such as retrograde ejaculation, urinary incontinence, hematuria, urethral strictures, bladder neck sclerosis, and other adverse events, it is necessary to apply minimally invasive surgical methods such as superselective embolization of the prostatic arteries (PAE), particularly Proximal Embolization First Then Distal Embolization (PErFecTED). The data from 1,015 BPH patients who underwent endovascular surgery demonstrate the benefits of PErFecTED treatment during 24 months after surgery. Both Quality of Life score and International Prostate Symptom Score were around three times better in the PErFecTED group and remained stable during the entire observation period. However, the technique needs to be improved due to the high risk of postembolization syndrome.

BACKGROUND: Improving the results of treatment of patients with chronic prostatitis is one of the important problems of modern urology. AIM: To compare the effect of ozone therapy and hypercapnic therapy on the hemodynamics of the prostate and immune status in patients with chronic abacterial prostatitis. MATERIALS AND METHODS: The study included 58 patients with chronic abacterial prostatitis, who were divided into three groups. Patients of the 1st group (n = 18) received standard therapy. Patients of the 2nd group additionally underwent a course of transrectal ozone therapy for 10 days. Patients of the 3rd group, in addition to the basic therapy, performed training on a breathing simulator to obtain the effect of hypercapnic hypoxia; the course of treatment consisted of 10 daily trainings. The effectiveness of therapy was assessed using the NIH-CPSI questionnaire. To assess the immune status of patients, we studied the content of IgA, IgG and IgM in the blood, the activity of the pro-inflammatory cytokines IL-1, TNF-, IL-6 in the blood serum and IL-8 in the urine. The state of blood flow in the prostate gland was assessed using laser Doppler flowmetry, as well as TRUS performed in the color Doppler imaging mode. The control group included 22 healthy men. RESULTS: In patients with chronic abacterial prostatitis hemodynamic and microcirculatory changes in the prostate gland were revealed, which were accompanied by characteristic clinical manifestations, urinary disorders, as well as impaired immune status in the form of an increase in the content of interleukins and tumor necrosis factor. The use of basic therapy (1st group) helps to reduce the clinical manifestations of chronic abacterial prostatitis, but its effect on the immune status, hemodynamics and microcirculation of the prostate gland is insufficiently expressed. Complex therapy, supplemented by training on a breathing simulator using the effect of hypercapnic hypoxia, has a positive effect on the course of the disease (3rd group). This type of therapy is able to improve the microcirculation of the prostate gland, increasing the index of microcirculation efficiency and average blood flow, reducing the shunting rates, but its effect on immunity is lower than in patients whose treatment included transrectal ozone therapy (2nd group). This type of treatment leads to a decrease in the activity of the pro-inflammatory cytokines IL-1, TNF-, IL-6 in the blood serum, and IL-8 in the urine, but at the same time does not have a sufficient effect on prostate hemodynamics and microcirculation. CONCLUSIONS: In patients with CAP with pronounced disorders of the immune status, complex treatment is indicated, supplemented by transrectal ozone therapy, and in the presence of pronounced hemodynamic disorders of the prostate gland, complex therapy is indicated, supplemented by the use of the effect of hypercapnic hypoxia.

The consequences of the pandemic caused by a new coronavirus infection have forced one to reconsider generally accepted methods of treatment and, taking into account the consequences, to find new therapeutic tools. As practice shows, infection caused by COVID-19 virus is a danger not only in the acute stage of the disease, but also in the late postinfection period, announcing itself with a variety of complications. In andrological practice, the greatest interest is caused by the influence of coronavirus infection on the reproductive organs of the male urogenital system. The use of the drug ‘Pineamine’ in the treatment of post-coital complications has shown high efficacy and safety in men. Studies in this direction are continuing.

Introduction. Chronic interstitial cystitis is considered a non-bacterial inflammation in the submucosal layer that is difficult to treat with traditional means due to the development of tissue hypoxia and activation of the peripheral nervous system involving a large number of pain receptors. Objective. To evaluate the effectiveness of general magnetic and oxygen therapy in the treatment of chronic interstitial cystitis with severe pain. Materials and methods. The clinical study involved 17 women with chronic interstitial cystitis/chronic pelvic pain syndrome who received a course of general magnetic and oxygen therapy. Quantitative criteria for clinical signs were evaluated using the questionnaire for assessing symptoms of diseases of the genitourinary system ‘OSZ - IPPS-MS’ before and after treatment. Results. A decrease in the absolute value of the "Irritativ symptom" scale of 65.2% was recorded. The score on the "Painful symptom" scale decreased by 9 times from its initial level, a significant decrease in the "score" of the "Psychosomatic symptom" scale by 63.75%. Reduction of the total score "Total score" at the end of the combined course of physiotherapeutic rehabilitation by 68.62%. The "Motivational scale" indicator at the end of treatment decreased by 62.50%, which corresponds to "awareness of the fact of the disease with a moderate degree of readiness to undergo treatment". This dynamic is explained by the improvement in the clinical and psychosomatic symptoms of the disease, and its moderate value at the end of treatment is associated with their motivation for subsequent regular preventive rehabilitation measures. Conclusion. The impact of general magnetic therapy and hyperbaric oxygen therapy for interstitial cystitis is accompanied by a significant reduction in pain and irritative symptoms with an effective correction of psychoneurosomatic disorders.

BACKGROUND: Increasing the effectiveness of the treatment of chronic bacterial prostatitis is an actual problem of modern urology. AIM: The aim of the study was to study the effectiveness of complex treatment of patients with chronic bacterial prostatitis using Prostatex. MATERIALS AND METHODS: This study included 94 patients with chronic bacterial prostatitis aged 21 to 45 years. Patients of group I (n = 47) received standard antibiotic therapy (levofloxacin at a dose of 500 mg 2 times a day for 28 days), and patients of group II (n = 47) received standard antibiotic therapy combined with the prescription of Prostatex in the form of rectal suppositories 10 mg once a day. RESULTS: The overall clinical efficacy of treatment in patients of group II was 2 times higher than in patients of group I. After treatment in patients of group II compared with group I a statistically significant decrease in chronic bacterial prostatitis symptoms according to the NIH-CPSI and IPSS questionnaires was recorded. Eradication of microflora in 91.4% of patients of group II was achieved, there was a significant decrease in prostate volume, an increase in the average volumetric flow rate of urine by 89.8%, normalization of perfusion parameters and the index of microcirculation efficiency. CONCLUSIONS: The results of the study showed that the use of Prostatex in the complex treatment of chronic bacterial prostatitis patients has a positive effect on the main symptoms of chronic prostatitis, significantly reducing pain, urination disorders and improving sexual function. This therapy helps to reduce the volume of the prostate and the volume of residual urine, restores microcirculation in the prostate gland and can be recommended in this category of patients.

BACKGROUND: The most dangerous disease in the structure of urinary tract infections during pregnancy is pyelonephritis. Favorable ground for its occurrence is created by anatomical and physiological changes in the urinary system in pregnant women against the background of gestational restructuring of the body. It seems very relevant to study the constitutional features of pregnant women with pyelonephritis and reference points - markers associated with the risk of developing pyelonephritis, the individual characteristics of its course and the effectiveness of therapy using the fundamental basis of clinical anthropology. AIM: Evaluation and comparative analysis of anthropometric and bioelectrical impedance body parameters in pregnant women with pyelonephritis. MATERIALS AND METHODS: The study included 94 pregnant women with pyelonephritis hospitalized in the urological department of the Clinical Regional Hospital (Krasnoyarsk) from 2019 to 2021. In addition to traditional tests, anthropometric and bioelectrical impedance analysis was carried out to assess the constitutional features and criteria of normal and pathological variability boundaries of pregnant women with pyelonephritis. The control group included 39 women with physiological course of pregnancy without urological diseases. RESULTS: The constitutional identification in the group of women with pyelonephritis in pregnancy was dominated by the mesomorph body type, with a smaller proportion presenting the endomorph type and the rarely detected central and ectomorph types. Vector analysis of soma components in pregnant women with pyelonephritis are characterized by high mesomorph scores reflecting the degree of skeletal and muscular development compared to the control group, with the lowest ectomorph values. According to bioelectrical impedance analysis, most patients have significant differences in a number of body composition parameters. Morphometric features of the pelvicalyceal system on the affected side are most prominent in the representatives of endomorph and central body types. There are significant correlations between the degree of pelvicalyceal system dilatation on the affected side and anthropometric and bioimpedance parameters of body composition. CONCLUSION: The study revealed a number of clinical and anthropometric parallels and constitutional features of pregnant women with pyelonephritis with the characteristics of the component body composition. Relationships have been established between various indicators, which at first glance are not related to each other, but have a significant impact on the clinical manifestations of gestational pyelonephritis. The results of the pilot study and further development of the methodology will make it possible to determine the most significant constitutional predictors of the development of pyelonephritis in pregnancy and the possibility of conducting preventive therapy.